- Elevance Health (Atlanta, GA)
- …services only, and there is licensed staff supervision. + Previous experience in case management / utilization management with a broad range of experience with ... facility-based and outpatient professional treatment health benefits through telephonic or written review . Primary duties may include but are not limited to: + Uses… more
- Luke Staffing (Fort Bragg, NC)
- …+ Comply with regulatory, MTF, and Joint Commission quality inspection/ peer review / utilization management requirements, and applicable system applications. ... and able to work with various personalities. Team work skills required. Time management skills required. The ability to meet deadlines in a deadline intensive… more
- UnityPoint Health (Waterloo, IA)
- …patient population, ensuring that adequate discharge plans are in place and completing utilization management and quality review activities. Care is provided ... Sign On Bonus: $7,500 + FTE/Hours per pay period: 0.9 + Department: Case Management + Shift: Mon-Friday, 0800-1630, some weekends and one holiday/year. + Job ID:… more
- Bowery Residents Committee (Manhattan, NY)
- …and crisis intervention. Gather and review documentation as requested for utilization management reviews of clients on caseload including completion of ... MSW or CASAC-T License required. LMHC or LMSW preferred. Excellent time management skills. Bachelors strongly preferred. Knowledge of OASAS rules and regulations and… more
- LA Care Health Plan (Los Angeles, CA)
- …multi-departmental (Member Services, Product Network Operations (PNO), Claims, Utilization Management (UM), Pharmacy, Medicare Enrollment/Disenrollment, Sales ... translations for members' correspondence into the appropriate languages. As requested review documents submitted by C&L to ensure proper translation and culturally… more
- Atlantic Health System (Morristown, NJ)
- …including preparing clinical updates and data metrics. + Plans and implements drug utilization management and quality improvement plans. + Liaison with site ... with site and enterprise pharmacy teams to support formulary management and pharmacoeconomic initiatives + Providing drug information to...100 Accountable Care Organizations to Know - Becker's Hospital Review + Best Employers for Workers over 50 -… more
- Highland Hospital (Rochester, NY)
- …benefits, identifies and resolves coordination of benefits discrepancies, and notifies Utilization Management of additional clinical requests **Salary Range:** ... information is on file and accurately documented. These activities include review diagnosis and history for correct insurance coverage, insurance eligibility and… more
- Louisiana Department of State Civil Service (Houma, LA)
- …issues impacting care in a succinct and timely manner. + Consistently meets Utilization Management and billable services expectations + Maintain knowledge of ... for clients who present with mental health and addictive disorders + Review diagnosis, evaluation and treatment plans in collaboration with clients and/or… more
- Intermountain Health (Las Vegas, NV)
- …institution. + Care Management Certification + Demonstrated experience in case management , utilization review , or discharge planning. + BLS Certified ... The RN Ambulatory Care Manager I delivers comprehensive ambulatory care management services to identified patients. Leveraging clinical expertise, this role involves… more
- Intermountain Health (Butte, MT)
- …+ Case Management Certification + Demonstrated experience in case management , utilization review , value-based care, and/or discharge planning. ... + Case Management Certification + Demonstrated experience in case management , utilization review , value-based care, and/or discharge planning.… more
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